Stephen James Mikola, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

MO12723 Issued in MO

Practice address

777 S New Ballas Rd
Suite 202W
Creve Coeur, MO 63141-8705

Phone

(314) 872-3936

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194737338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 POINTER LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242020",
            "telephone_number": "314-993-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD",
            "address_2": "SUITE 202W",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631418705",
            "telephone_number": "314-872-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLA",
        "first_name": "STEPHEN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "MO12723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.